Provider Demographics
NPI:1932940905
Name:CHRISTENSEN, ROBERT PAUL
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:PAUL
Last Name:CHRISTENSEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3560 BRIDGEPORT WAY W STE 3A
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-4446
Mailing Address - Country:US
Mailing Address - Phone:253-881-0014
Mailing Address - Fax:
Practice Address - Street 1:5933 NE WIN SIVERS DR STE 201
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-9056
Practice Address - Country:US
Practice Address - Phone:503-937-0233
Practice Address - Fax:503-253-0501
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-04
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0188772352251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health